In February of 2013, the Tennessee Department of Health issued its first public health advisory on electronic nicotine delivery systems. After reviewing a growing body of unbiased, scientific research, TDH is issuing an updated advisory that provides more information and urges current and potential users to understand new evidence of risks associated with e-cigarettes and similar devices.

"We recognize and applaud the many Tennesseans who have made resolutions to be healthier in 2017, particularly those who are battling a dependence on nicotine," said TDH Commissioner John Dreyzehner, MD, MPH. "We know some may consider the use of electronic cigarettes to quit conventional tobacco products. Both current and potential users of all electronic nicotine delivery systems should be aware e-cigarettes are not approved as smoking cessation devices by the FDA or CDC, and their use may create a variety of dangers."

Among the risks cited in the new TDH Public Health Advisory are:

Liquid nicotine, a primary ingredient in many e-cigarettes and similar devices, can be fatal if ingested or absorbed through the skin. Users should protect themselves and not allow children access to the liquids. Parents who suspect their child may have swallowed chemicals or batteries intended for e-cigarettes should seek medical help immediately.

Due to explosions of e-cigs and similar devices, the U.S. Dept. of Transportation has banned battery-powered electronic smoking devices in checked baggage. Fires and explosions of the devices have been documented to cause painful injuries.

In a report released December 8, 2016, the U.S. Surgeon General called e-cigarettes an emerging public health threat to the nation's youth. The report warned of the dangers of e-cigarette use among youth and young adults, and the risk of creating a new generation of nicotine-addicted Americans.

Pregnant women should not use the devices as exposure to nicotine during pregnancy may have negative long-term health effects for a baby, impacting the nervous and circulatory systems, along with the brain and other organs.

Parents should understand e-cigarette use by teens may create a nicotine addiction and be a gateway to use of conventional tobacco products.

Persons should not share e-cigarettes or similar devices; doing so may spread a variety of illnesses. Additionally, the devices have been used to deliver intoxicating agents such as gamma butyrolactone, more commonly known as the date rape drug.

Emissions from e-cigarettes may contain a variety of chemicals that may be harmful to both humans and pets.

"Our ongoing review of research gives us significant concerns about the negative impacts e-cigarettes and similar devices can have for those who use them, for those who are exposed to second-hand emissions and for children who may swallow chemicals or batteries," said Dreyzehner. "Our recommendation is that people who are considering them for smoking cessation should instead use CDC-approved methods. Those who are thinking about them for recreational purposes should know they are placing themselves at risk for developing a life-long nicotine addiction or exposing themselves and others to substantial harm."

For assistance and support in ending a nicotine addiction, TDH recommends calling the toll-free Tennessee Tobacco QuitLine, 1-800-QUIT-NOW (1-800-784-8669) or visiting www.tnquitline.org for assistance.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. TDH has facilities in all 95 counties and provides direct services for more than one in five Tennesseans annually as well as indirect services for everyone in the state, including emergency response to health threats, licensure of health professionals, regulation of health care facilities and inspection of food service establishments. Learn more about TDH services and programs at www.tn.gov/health.